Neuropsychological functioning in obsessive-compulsive disorder: A comparison of patients with and without a history of tics
The significant degree of heterogeneity found within the OCD population has generated recent interest in identifying and establishing subtypes of the disorder. The current study sought to examine and compare the neuropsychological performance of two purported subtypes of OCD patients, those who exhibit tics and those who do not exhibit tics. A clinical sample of 20 patients with OCD, 10 patients in each group, was recruited through two outpatient treatment centers. Patients were assessed using the Wisconsin Card Sorting Test, the Rey-Osterrieth Complex Figure Test, and an adaptive decision making test. The effects of attention, intelligence, and depression were controlled for in analyses. Results indicate that OCD patients without tics demonstrate very specific neuropsychological deficits, whereas OCD patients with a history of tics demonstrate broader based deficits. With regard to executive functioning, the OCD group without tics demonstrated specific difficulty in shifting set, whereas the OCD group with tics demonstrated difficulties in set-formation and set-maintenance, as well as difficulty shifting set. With regard to memory, both the OCD group with tics and the OCD group without tics demonstrated significantly below average memory performance, which was found to be related to initial organizational strategies for both groups. The OCD group with tics was also shown to have greater impairment in visuospatial functioning. The distinctive neuropsychological profiles of the two groups lend support to the notion that the presence of tics may be a valid means for subtyping individuals with OCD. Clinical implications are highlighted and directions for future research studies are suggested.
0622: Clinical psychology